HIPAA Authorization

MEDIXALL PLATFORM

HIPAA Authorization

MediXall offers services, such as helping you to find and learn about nearby healthcare providers, booking appointments with the healthcare provider(s) of your choice (each, “Your Healthcare Provider”) and managing and forwarding your health history forms and other health-related information to share with Your Healthcare Providers (“MediXall Services”). As part of providing the MediXall Services, MediXall may collect, use, share, and exchange your health history forms and other health-related information with Your Healthcare Providers. Under a federal law called the Health Insurance Portability and Accountability Act (“HIPAA”), some of this health and health-related information may be considered “protected health information” or “PHI” if such information is received from or on behalf of Your Healthcare Providers.

Safeguards for PHI

HIPAA protects the privacy and security of your PHI by limiting the uses and disclosures of PHI by most healthcare providers and by health plans (called “Covered Entities”) as well as companies, like MediXall, that provide certain types of assistance to Covered Entities (called “Business Associates”). Under certain circumstances described in HIPAA, an individual needs to sign an Authorization form before a Covered Entity, like Your Healthcare Provider(s), can disclose protected health information to a third party.

Non-Protected Health Information

As a condition of creating your MediXall account, you are required to read and agree to MediXall’s Privacy Policy. MediXall’s Privacy Policy explains how MediXall processes and shares information received from you that is not covered by HIPAA (“Non-PHI”).

Your PHI Authorization

The purpose of this MediXall Authorization (“Authorization”) is to request your written permission to allow MediXall to use and disclose your PHI in the same way as we use and disclose your Non-PHI. If MediXall is a Business Associate of Your Healthcare Providers, MediXall needs your Authorization to be able to use and disclose your PHI in the same way it can currently use and disclose your Non-PHI when MediXall is not working on behalf of Your Healthcare Providers, but is instead working on its own behalf. Therefore, when MediXall relies on this Authorization, and uses and discloses PHI as described in this Authorization, it is not working as a Business Associate and the HIPAA requirements that apply to Business Associates will not apply to such uses and disclosures.

If you e-sign this Authorization, you give your permission to MediXall to retain your PHI and to use and/or disclose your PHI in the same way that you have agreed that your Non-PHI can be used and disclosed.

Specifically, you agree that MediXall can use your PHI to:

enable and customize your use of the MediXall Services;

provide you alerts or other MediXall Services regarding future appointments;

notify you regarding providers we think you may be interested in learning more about;

share information with you regarding services, products or resources about which we think you may be interested in learning more;

provide you with updates and information about the MediXall Services;

market to you about MediXall and third party products and services;

conduct analysis for MediXall’s business purposes;

support development of the MediXall Services; and

create de-identified information and then use and disclose this information in any way permitted by law, including to third parties in connection with their commercial and marketing efforts.

You also agree that MediXall can disclose your PHI to:

third parties assisting MediXall with any of the uses described above;

Your Healthcare Providers to enable them to refer you to, and make appointments with, other providers on your behalf, or to perform an analysis on potential health issues or treatments, provided that you choose to use the applicable MediXall Service;

a third party as part of a potential merger, sale or acquisition of MediXall;

our business partners who assist us by performing core services (such as hosting, billing, fulfillment, or data storage and security) related to the operation or provision of our services, even when MediXall is no longer working on behalf of Your Healthcare Providers;

a provider of medical services, in the event of an emergency; and

organizations that collect, aggregate and organize your information so they can make it more easily accessible to your providers.

Redisclosure

If MediXall discloses your PHI, MediXall will require that the person or entity receiving your PHI agrees to only use and disclose your PHI to carry out its specific business obligations to MediXall or for the permitted purpose of the disclosure (as described above). MediXall cannot, however, guarantee that any such person or entity to which MediXall discloses your PHI or other information will not re-disclose it in ways that you or we did not intend or permit.

Expiration and Revocation of Authorization

Your Authorization remains in effect until you provide written notice of revocation to MediXall.

YOU CAN CHANGE YOUR MIND AND REVOKE THIS AUTHORIZATION AT ANY TIME AND FOR ANY (OR NO) REASON.

If you wish to revoke this Authorization, you must notify MediXall by submitting a revocation through your account settings page. Your decision not to execute this Authorization or to revoke it at any time will not affect your ability to use certain of the MediXall Services. A Revocation of Authorization is effective after you submit it to MediXall, but it does not have any effect on MediXall’s prior actions taken in reliance on the Authorization before revoked.

Once MediXall receives your Revocation of Authorization, MediXall can only use and disclose your PHI as permitted in MediXall’s agreements with Your Healthcare Provider(s). Your Revocation of Authorization does not affect MediXall’s use of your Non-PHI.

We will make available to Your Healthcare Provider(s), current and past, your agreement to or revocation of this Authorization.